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They are particularly useful for individuals who have difficulty absorbing B12 from food, such as those with certain digestive issues, older adults, vegans, and vegetarians

Thats what Matteo Daniele, the owner of Personal Touch Training in New Yorks Westchester County, did a few years ago

A French study found a strong association with elevated serum B12 and cirrhosis and hepatitis (Deneuville, 2009)

doi: 10.1016/S0928-4257(01)00042-0

And then that's the end of the conversation. Through his work, he says he is encouraging clinicians to come to the table and help supervise people, with checking their bloods and doing echocardiograms (heart monitoring)